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FIVIC SUPPORT SERVICES NPI 1164132148


NPI Information

NPI: 1164132148
Provider Name: FIVIC SUPPORT SERVICES
Classification: Home Health - 251E00000X
Entity Type: Organization
Address:
209 PASSAIC AVE
BELLEVILLE, NJ
ZIP 07109
Phone: (973) 392-0430
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FIVIC SUPPORT SERVICES is a home health in Belleville, NJ. The provider is a public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. FIVIC SUPPORT SERVICES NPI is 1164132148. The provider is registered as an organization entity type.

The provider's business location address is:

209 PASSAIC AVE
BELLEVILLE, NJ
ZIP 07109-960
Phone: (973) 392-0430

The provider's authorized official is Ama J Baffoe .
The authorized official title is Executive Director and has the following contact phone number (973) 392-0430.

The enumeration date for this NPI number is 11/30/2022 and was last updated on 11/30/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1253Z00000XIn Home Supportive CareNo
2261QA0600XClinic/CenterAdult Day CareNo
3261QC1500XClinic/CenterCommunity HealthNo
4261QH0100XClinic/CenterHealth ServiceNo
5261QP2000XClinic/CenterPhysical TherapyNo
6385H00000XRespite CareNo
7251E00000XHome HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11946MEDICAIDNEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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